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Here are five steps for surgery center administrators to identify and reverse unhappy surgeons before it's too late.

1. Notice the signs of an unhappy surgeon. Surgeons could be unhappy with their experience at a surgery center for several different reasons. Administrators must know the signs of a surgeon's unhappiness and react quickly to fix the problem. Taking cases out of the ASC is the most common sign that a surgeon is unhappy, says Daniel C. Daube, MD, founder and director of Gulf Coast Facial Plastics & ENT Center in Panama City, Fla.

"If a surgeon has a high volume of cases, they can try to hold the center ransom or they will move their cases to other centers," says Dr. Daube. "All the members need to be sensitive to the fellow physician's state of mind. If they think a surgeon is unhappy, they need to contact a managing member and have on person coordinate the solution for the real or perceived problem."

Before that stage, you can usually identify an unhappy surgeon by their conversation with other physicians and staff members. "One of the biggest signs that surgeons are unhappy is their complaining to staff members," says Joe Zasa, co-founder and managing partner of ASD Management. "The second is when their patients start complaining."

2. Proactively communicate with key physicians. Identify which physicians within the surgery center seem to have a positive relationship with most of the surgeons and communicate with them regularly to make sure everyone is happy. If someone shows signs of unhappiness, administrators will find out sooner through these conversations.

"If a surgeon has a high volume of cases, they can try to hold the center ransom or they will move their cases to other centers," says Dr. Daube. "All the members need to be sensitive to the fellow physician's state of mind. If they think a surgeon is unhappy, they need to contact a managing member and have one person coordinate the solution for the real or perceived problem."

3. Identify and confront the problem. After an unhappy surgeon is brought to your attention, sit down with the surgeon and identify the problem. If possible, find a solution. The most common problems are associated with money or scheduling at the center.

"If the surgeon feels they are doing a disproportionate amount of work but not receiving dividends that reflect what they perceive as their level of work, this could be a problem," says Dr. Daube. "Sometimes surgeons aren't sure why they are upset so the most important step is taking time to find the problem."

In this example, the surgeon might say he is upset about the dividends, but the real problem is his personal finances aren't in shape and he was hoping the surgery center would help him more. "The problem is often more complex than just owning enough shares," says Dr. Daube.

4. Open conversation about solutions. Find solutions for the problem and open a dialogue with all surgeons involved to accommodate their needs. "The open discourse is key," says Mr. Zasa. "Figure out what their needs are and what you can do to accommodate them. Talk to them about how they feel so at the end of the day you understand their expectations and accommodate their needs."

Ask the surgeon what you can do for them, which is part of the every day operations at the center. "These are all problems that have solutions," says Mr. Zasa. "It could be a function of staff not being prepared, patients having a bad experience or not getting on the scheduled time they want. These are fixable problems."

5. Send out a consistent message or solution. After identifying the problem and a potential solution, relay any changes to all surgeons involved so everyone has a consistent solution to the problem.